Healthcare Provider Details
I. General information
NPI: 1609095918
Provider Name (Legal Business Name): MARIA V SUURNA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/25/2007
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1400 NW 12TH AVE
MIAMI FL
33136-1003
US
IV. Provider business mailing address
1120 NW 14TH ST FL 5
MIAMI FL
33136-2107
US
V. Phone/Fax
- Phone: 305-325-5511
- Fax:
- Phone: 305-243-3564
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207YS0012X |
| Taxonomy | Sleep Medicine (Otolaryngology) Physician |
| License Number | ME155641 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | ME155641 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: